What Are the Stages of Sjogren's Syndrome?

By Lynn Dosch

Sjogren’s syndrome is an autoimmune disorder affecting approximately four million Americans, according to the Sjogren's Syndrome Foundation. While both men and women of any age may be diagnosed with Sjogren’s, it is most common in women over 40. About 50 percent of sufferers have primary Sjogren's syndrome, meaning they have no other autoimmune disease. The others have secondary Sjogren’s syndrome, meaning occurs in conjunction with another autoimmune disorder, such as lupus or rheumatoid arthritis. Although the symptoms of Sjogren’s syndrome can be roughly divided into three stages, not every person diagnosed with the disease will experience each stage.

Stage I

Stage I of Sjogren’s syndrome affects your salivary glands and tear ducts. Reduced saliva causes your mouth to be dry, which can make speaking and eating difficult. It can also cause dental problems and oral infections. Reduced tearing makes your eyes feel dry and gritty. You may also experience sensitivity to light and a feeling of eye fatigue or strain. Your senses of smell and taste are also affected, and you may have muscle aches, joint pain, sleep disorders and fatigue. If you are like 45 percent of Sjogren’s patients, your disease will remain in Stage I.

Stage II

In Stage II of Sjogren’s syndrome, you continue to experience the symptoms of Stage I, but the chronic inflammation that characterizes Sjogren’s may begin to affect the lungs, kidneys, liver, blood vessels and skin. This is caused by the lymphocytes, which previously only attacked the healthy cells of the tears ducts and salivary glands, attacking other healthy body tissues as well. The symptoms you experience in Stage II depend on which tissues your lymphocytes are attacking. About half of the people diagnosed with Sjogren’s will progress to this stage.

Stage III

In the Stage III of Sjogren's syndrome, which affects approximately 5 percent of patients, the lymphocytes become cancerous, resulting in lymphomas. The most frequently diagnosed is non-Hodgkin’s B-cell lymphoma, seen in 44 percent of patients.

Diagnosis

Your doctor has many ways to diagnose Sjogren’s syndrome. Typically she'll begin by ordering several different kinds of blood tests to see whether there are signs of inflammation or certain antibodies in your blood, which develop in response to Sjogren’s syndrome. Eye tests and diagnostic imaging tests are also helpful diagnostic tools. Your doctor may also biopsy the salivary glands, or she may take samples of your saliva and urine.

Treatment

Some patients in Stage I of Sjogren’s are able to manage very well by using eye drops and always having water handy. If those remedies don’t work, or if you and your doctor choose to treat the condition more aggressively, your doctor may prescribe drugs to stimulate production of saliva, to reduce inflammation and even to suppress the immune system. Certain types of surgery are also available. Treatment, of course, depends on the symptoms you experience and the stage of your disease.

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